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Fractional ablation with a CO2 laser

As we age, our skin loses its fresh and smooth appearance because we lose collagen, develop areas of hyperpigmentation from sun exposure, and form wrinkles and creases. Today more people than ever are avoiding invasive procedures like the facelift because there are effective non-surgical options that allow them to return to work quickly with little downtime and discomfort.  Fractional ablation with a CO2 laser uses energy in the form of heat to precisely remove layers of damaged skin, which can be used to treat sun damage, fine and deep wrinkles, scars, and skin lesions.

CoolPeel® is a brand new way to safely, and comfortably deliver the benefits of a traditional CO2 resurfacing treatment. By targeting just the superficial layer of skin tissue, damaged skin is removed using heat, revealing younger and healthier looking skin. Many advances have been made to improve the side effects of CO2 treatments but ONLY the CoolPeel® can deliver a fractional ablative treatment without the downtime. There is minimal risk of hyperpigmentation, demarcation or induced infection.

How does a CO2 laser work?

Lasers used in aesthetics can have a variety of applications with the CO2 laser serving as one of the most widely used because its wavelength is well absorbed in water (also known as the chromophore). As skin contains a very high percentage of water, this makes the CO2 laser ideal for precise, safe ablation with good hemostasis or control of bleeding. When lasers are used for aesthetic purposes, we use laser energy to ablate or vaporize tissue while minimizing damage to the surrounding tissue. 

Fully ablative treatment with a CO2 laser involves removal of the entire epidermis, which stimulates the regrowth of a younger-looking epidermis, collagenesis and remodeling of the dermis. The aim of fully ablative resurfacing is to ablate the epidermis cleanly off the dermis and leave a zone of dermis that would promote the wound healing process, which gives great results but comes with significant discomfort and downtime, as well as the risk of infection and scarring. 

Fractional ablation is a newer approach that uses microablative columns of vaporization involving both the epidermis and dermis, which stimulates re-epithelialization in the normal surrounding undamaged skin and wound healing under the protection of an intact epidermis to give similar results to full ablation without the discomfort, downtime or risk of complications.    

Nonablative methods are not considered as effective as the ablative methods because they leave the epidermis intact, limiting the healing response. 

Click here to read a review article about CO2 laser treatments  

What conditions can be treated with a CO2 laser?

Fractional ablation with a CO2 laser can be used to treat the following conditions:

  • Sun damage including freckles, sun spots, and hyperpigmentation
  • Fine and deep wrinkles
  • Acne and acne scars
  • Skin laxity and uneven texture
  • Scars
  • Large pores
  • Stretch marks

Fractional ablation can also be performed on body parts other than the face, including the neck, decolletage, chest, arms and hands for skin rejuvenation. 

Can CO2 laser treatments be performed on any Fitzpatrick skin type?

We offer two primary types of fractional ablation with a CO2 laser at Studio R Aesthetics, with the primary difference being how deep we perform the ablation.

The Coolpeel treatment is limited to the epidermal layer and does not reach the epidermal-dermal junction, where the melanocytes are found. Because we are limiting treatment to the epidermis, the Coolpeel can be performed on any skin type with minimal risk of postinflammatory hyperpigmentation. Downtime is minimal and patients typically look like they have a sunburn with rough skin for 2-3 days. 

The Deka treatment goes deeper into the dermis, beyond the epidermal-dermal junction. This treatment can only be performed on Fitzpatrick I-III patients because of the risk of PIH in patients with a higher Fitzpatrick type. Patients typically experience seeping and skin crusting for up to 10 days after more aggressive treatments. 

Is treatment with a CO2 laser painful?

At Studio R Aesthetics, we ensure that our patients have access to treatments without fear of intolerable discomfort. We can apply the strongest topical anesthetic available to the treatment site for at least 30 minutes prior to performing the procedure, which desensitizes the nerve endings in the epidermis and reduces sensations from a CO2 laser treatment.

We can use a Chiller device to blow cold air at -30 degrees on the treatment area, which further desensitizes the nerve endings and reduces pain. Pronox cannot be used during laser treatments due to the risk of fire.

Are there any side effects or complications related to a CO2 laser treatment?

There are both risks and complications associated with all laser treatment procedures of the skin. 

Infection: Although infection following laser skin treatment is unusual, bacterial, fungal, and viral infections can occur. Herpes simplex virus infections around the mouth or other areas of the face can occur following a more aggressive laser treatment. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections in the mouth area. We typically prescribe valacyclovir prior to aggressive fractional ablation treatments. 

Scarring: Although normal healing after the procedure is expected, abnormal scars may occur both in the skin and deeper tissues. In rare cases, keloid scars may result. To minimize the chances of scarring, it is critical that all patients follow the post-treatment instructions provided by our staff.

Burns: Laser energy can produce burns. Burns are rare yet represent the effect of heat produced within the tissues by laser energy. Additional treatment may be necessary to treat laser burns.

Redness/Swelling/Bruising: Redness (erythema) or swelling (edema) of the treated area is common and may occur. There also may be some bruising.

Color Change: During the healing process, there is a slight possibility that the treated area may become either lighter (hypopigmentation) or darker (hyperpigmentation) in color compared to the surrounding skin.  This is usually temporary, but, on a rare occasion, it may be permanent.

How does fractional ablation work?

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Dr. Itri introduces the Coolpeel laser

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CO2 Laser Ablation FAQs

I got a facial done by Ms. Morris a few weeks ago. I am trying to heal my skin more natural since i got off my prescriptions. She is absolutely fantastic! I am getting facials done until she says i can get a chemical peel to help with my acne. So excited for it. Even if you don't have skin issues, treat yourself! It is worth it. I wish i could afford to go every week haha i totally would. Edit: not sure if she is "dr or md" but she's a licensed esthetician 🙂

Kyleigh Falls
May 29, 2023

Very thorough and informative! The best!!

Theresa Guiff
May 26, 2023


Cory Trese
May 26, 2023

Excellent source for peptide treatments in Charlottesville.

Katie Martin
May 22, 2023

I love it here! I was new to the area and needed someone I can trust with all of my aesthetic needs. I had been to another medspa and wasn't quite impressed. So I scheduled a Botox appointment with Dr. Segura and after discussing my concerns I decided to go with Xeomin instead. Dr. Segura was so gentle and made sure I was comfortable the whole time. My comfort mattered to her! I've never experienced that before. She was so amazing that I decided to schedule an appointment with Michelle. I received a HydraFacial and brow wax and was blown away with how meticulous she is. I'm looking forward to my next visit!

Carrie Hodgkins
May 16, 2023

Thrilled Michelle has joined this MedSpa, she’s a lash magician.

May 12, 2023

Studio R Aesthetics is amazing! I get my lash extensions done by Michelle and she is so wonderful. The extensions are beautiful and long lasting. Dr. Segura and staff are all so sweet and professional. The studio is beautiful and flawless as well!

martha thomas
May 11, 2023

I had been scheduling my facials with Michelle Morris at her previous place of employment, so was thrilled to “find” her at Studio R. There are many options in Charlottesville for facial treatments, but none I have found with Michelle’s passion for, and commitment to, continuing to educate herself in all things skin care. So glad she landed in such a wonderful environment- I thoroughly enjoyed my experience there and look forward to getting my daughter booked with her as well.

Heather Glass
May 8, 2023

Beautiful office and great service! I felt very comfortable and able to discuss treatment options to choose the best for me. Can’t wait to come back!

Margaret Haley
May 6, 2023

I have been coming here even when she was at the old location. The best work done and they ensure that you feel comfortable during any spa treatment.

Dr. Segura is simply amazing! She took all my worries and concerns into account and gave me honest feedback. Not to mention she does an incredible job! I have not felt this good about myself in many years! She gave me back confidence and I could not be more appreciative of her! The staff are amazing and treat you with such kindness! Fantastic place with remarkable results!

May 5, 2023

Amazingly awesome service—wonderful experience!!

Tiffany Trent
May 3, 2023

Dr. Brandy Segura was very professional and thorough. The office is beautiful!

April 29, 2023

This place was amazing. I saw Michelle to get a Brazilian sugaring and an eyebrow wax and tint. She is very knowledgeable about what is best for your skin. The services received were phenomenal. All the staff I saw coming in and leaving were very sweet and helpful, as well. 10/10 recommend!

Julie P.
April 29, 2023

Michelle is the best! I’ve been going to her for years for multiple services and she’s never let me down!

Anne Beyer Turner
April 28, 2023

I first came to Studio R Aesthetics last year in September. We had just moved from Los Angeles to C-ville and I was in desperate need of a Botox refresher. With my last Cosmetic Nurse it took me a long time to get the right level of Botox. I'm an actor and need to maintain mobility in my face, yet need to look fresh and still somewhat my (on camera-) age. I was so nervous finding a new Botox professional, but meeting Dr. Segura changed everything! First of all, I think I've never actually had a d o c t o r handle my injections, that was already very comforting. On top of that, Dr. Segura took a lot of time with me, listening and understanding my needs. She introduced me to Xeomin and we decided on a plan to find the right dosage starting with a little and gradually moving to the perfect amount. I was absolutely amazed by the professionalism and consultation. I just came back from filming on a hot TV show and I felt amazing on set. Thank you, Doc! I will see y'all next month. 🙂

yasmin garcia
April 22, 2023

Hands down the best Sugar waxing service in the C-Ville area!

Beth Cormier
March 25, 2023

It is always such a great, relaxing experience! Everyone is so friendly and I love the results!

Melody Bowman
March 24, 2023

I met with the physician Dr. Segura to discuss micro needling and she explained the procedure and answered all of the questions I had so that I felt comfortable and prepared. She addressed the concerns I had with acne scarring and mentioned the micro needling option that would be most effective for my needs. I also got a MIC shot to boost my metabolism and the energy it gave me that week and the following week really helped me manage my stress and not feel exhausted. The staff were really nice and friendly and the office was clean and smelt nice. Definitely a facility I will return to for future services.

Carrie Horne
March 24, 2023

I’ve tried several other medical spas for fillers, but none have compared to the excellent knowledge and skill performed at Studio R Aesthetics. My body metabolizes filler very quickly, so I was given suggestions on different products to try that may better suit me - I haven’t had the opportunity to put them to the test yet since I got pregnant before my next appointment was needed, but as soon as I am able to, I’ll be coming back for more! Would definitely recommend!

March 17, 2023

I have seen Dr. Segura for hormone replacement therapy and weight loss. Her office has been so pleasant and available for questions and the atmosphere is very comforting. I will definitely continue to use Studio R!

March 10, 2023

Attentive, professional and well appointed med spa. Hydra facial was so moisturizing. I really saw improvement in my skin. Recommend!

Geri Dokos
March 7, 2023

Brandy is great!! This was my second visit and I have been very happy with the results!

River & Røse
March 6, 2023

I have used Studio R for a variety of procedures now. Each time I was given a very thorough consultation and treatment. The staff is very professional and knowledgeable. I have been very pleased with everything so far and look forward to future services here.

Mollie Eddings
March 6, 2023

Everyone is really helpful and friendly! Dr. Segura is great and has walked me through every step of the treatments and my plan of care.

Mariah Cowan
March 4, 2023

Brandy is amazing , knowledgeable, reassuring , and gentle. I will never recommend another doctor other than her. Thank you for the love and confidence you always give to me!

Dr Brandy is amazing I have been coming here for 2 years and she has done a beautiful job keeping me looking my best. And she’s a really nice person too! Highly recommend!!

Bailey LeBoeuf
March 3, 2023

Got lip filler for my first time and loved my results! Feel so much more confident, came back to get them even bigger. Definitely come here to get great results!

Pam Calary
March 3, 2023

Great dietician info!

nakayla woods
February 26, 2023

Raji was amazing, she took very good care of me. 10/10!! she did a full leg and also a brazilian wax.

Laura Kehr
February 25, 2023

Super knowledgeable and comfortable experience getting Dysport

cameron garner
February 24, 2023

Very nice and very experienced professionals!

Kasey Jernigan
February 20, 2023

Love this place! Dr. Segura is so thoughtful and careful. She has the lightest touch and gives honest assessments. I’m so happy with my treatment and will only come here.

Gina Mancuso
February 18, 2023

Love the new space! Dr. Segura is very professional and takes a lot of pride in her work. She is a lip magician! Have been going for over a year now, and would recommend her to anyone!

Maura Reynolds
February 15, 2023

Great doctor, explains everything- very professional and kind. Highly recommend her.

Brooke Lovelace
February 15, 2023

I love Studio R Aesthetics! I drive from Staunton. Would recommend 110%.

Keeghan Hale
February 14, 2023

Amazing! Love Dr. Segura and her team!

Kadee H
February 14, 2023

I came for a consultation and the atmosphere was so nice, clean and relaxing. Great music and the receptionist was so kind and friendly right away. I was nervous but the provider went over everything I should expect and made sure I felt set with the process I’d journey on! I didn’t feel rushed or judged, they had a great process.

Christy Morris
February 13, 2023

I love this place! They are super professional and know what they are doing!! Highly recommend

Sarah Wenslow
February 13, 2023

Amazing experience!

Laura Meyerhofer
February 13, 2023

Dr. Segura and the entire Studio R staff is so amazing!

Madolyn Miller
February 6, 2023

Love Dr. Segura!! I've been to her a few times for Xeomin treatments. I will definitely be back soon for other services 🙂

Jordan Long
January 31, 2023

THE BEST experience! Beautiful office with the nicest staff and best doctors! So glad I was referred to this office!

matthew street
January 27, 2023

Studio R Aesthetics is amazing! I first went to them to deal with a puffy and red face. Dr. Segura spent a lot of time consulting me and getting to know me and what may be the best for me. Over the course of the consultation, I learned that Dr. Itri was offering peptides to help prevent anti-aging. Before then, I had been purchasing those from a clinic and was looking for a doctor in town. I quickly made an appointment with Dr. Itri. I have been getting my peptides from Studio R for about 6 months now. I highly recommend this place for your health, wellness, fitness goals. When I turned 40 years old, I began to proactively look for ways to continue to be active and not succumb to the normal deterioration of testosterone and natural growth hormones . TRT and peptide therapy have been a game-changer for me to look and feel great. Having these services in Charlottesville from people I can trust makes it just that much better. I will continue to use Studio R Aesthetics for all my bio-identical and aesthetic needs.

Amanda Davis
January 26, 2023

Dr. Segura is amazing and so knowledgeable. My consultation was very informative and she explained all options for the areas i am most interested in getting treatment for. The office is beautiful and very clean. I cant wait to start my treatment plan!

Tamara Wood
January 3, 2023

I made a appointment with Dr Segura for a consultation and discussed my goals and she was very informative and explained everything. She told me what would be best for me and she worked with my budget. I made a appointment to start my treatments. My first appointment was amazing. Dr Segura explained everything in detail as she did it and made me feel comfortable. She told me to call her if I had any problems. I scheduled a follow up appointment for 2 weeks. I will definitely be back. Thank you very much!

Carilee Nieto
December 22, 2022

l have visited some spa in orange and charlotsville, when l found Studio.R, to be honest l was a bit doubtful about the place, but when l met dr Brandy she gave me a lot of confidence,and l really like that, She take her time to explain to me and to perform the corresponding treatment,l like it a lot and l think this will be my place for a long time.

heather lothamer
December 19, 2022

Dr. Segura is wonderful and I highly recommend Studio R! Great customer service and it’s always a treat to have an appointment with Dr. Segura.

Zoe Crues
December 14, 2022

Super informative and kind. Best place around.

Nancy Martinez
December 12, 2022

I went on Saturday for my treatment on Botox. She was so good explaining and so so polite and gentle that I have never experienced a specialist like her I will continue to go and I will recommend my friends to her. I love the way how she did my vote Botox and didn’t have any trouble at all no bruising anything like that and I will keep going back for further more treatments that I would like to get done. Thank you

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